A EMERGÊNCIA DAS MICOBACTERIOSES NÃO-TUBERCULOSAS (MNT)

panorama epidemiológico, fatores de risco e critérios diagnósticos

Abstract

Non-Tuberculous Mycobacteria (NTM) infections comprise a heterogeneous group of diseases caused by environmental mycobacteria, whose clinical relevance has significantly increased in recent decades. This chapter aims to provide a comprehensive analysis of the epidemiological scenario, risk factors, and diagnostic criteria associated with NTM, with emphasis on pulmonary manifestations. A global increase in incidence has been observed, particularly in middle- and high-income countries, associated with population aging, increased prevalence of chronic lung diseases, and expanded use of immunosuppressive therapies. NTM infections are mainly acquired through environmental exposure, with no sustained person-to-person transmission in most cases. Major risk factors include immunosuppression, bronchiectasis, chronic obstructive pulmonary disease, pulmonary fibrosis, and prior tuberculosis. Diagnosis remains challenging and requires integration of clinical, radiological, and microbiological criteria according to international guidelines. Distinguishing colonization from active disease is essential to avoid unnecessary treatment. Species identification is crucial for therapeutic decision-making, as treatment is prolonged and often associated with adverse effects. NTM infections represent an emerging public health concern, requiring improved epidemiological surveillance and professional training.